Lin Chun-Hui, Hsieh Cheng-Chieh, Chen Si-Yu, Chen Hong-Ru, Chen Szu-Chieh
Department of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan.
Department of Surgery, Division of General Surgery, Feng Yuan Hospital, Ministry of Health and Welfare, Taichung, 42055, Taiwan.
Heliyon. 2025 Jan 6;11(1):e41686. doi: 10.1016/j.heliyon.2025.e41686. eCollection 2025 Jan 15.
This study used the Disability-Adjusted Life Years (DALYs) to quantify the long-term trends for four cancers (oral cancer, colorectal cancer, breast cancer, and cervical cancer) that have undergone cancer screening in Taiwan.
DALYs were calculated as the sum of Years of Life Lost (YLL) due to premature mortality and Years Lived with Disability (YLD). YLLs were determined using cancer-specific mortality data from the Health Promotion Administration (HPA), Ministry of Health and Welfare, based on age-specific life expectancy. YLDs were estimated by combining the incidence rates of the cancers, average disability durations, and disability weights, with data sourced from the Taiwan Cancer Registry. Results were expressed as DALYs per 100,000 population.
The disease burden has significantly increased over the past 12 years. Oral cancer rose from 263 to 368 DALYs per 100,000 population (40 % increase), colorectal cancer from 343 to 563 DALYs (64 % increase), and breast cancer from 446 to 782 DALYs (75 % increase), while the burden of cervical cancer decreased from 168 to 147 DALYs per 100,000 population from 2010 to 2017, showing a 13 % reduction. At the cancer stages, the impact of YLDs was mostly at cancer stage IV (oral cancer), cancer stage 0 (colorectal and cervical cancer), and stage I (breast cancer).
Oral cancer increased by 40 %, colorectal cancer by 64 %, and breast cancer by 75 % from 2005 to 2017, while cervical cancer decreased by 13 % between 2010 and 2017. YLD contributions were highest in stage IV for oral cancer, stage 0 for colorectal and cervical cancers, and stage I for breast cancer. The highest DALYs consistently occurred in the 50-69 age group across all cancer types, highlighting the significant burden on middle-aged populations.
本研究采用伤残调整生命年（DALYs）来量化台湾地区已开展癌症筛查的四种癌症（口腔癌、结直肠癌、乳腺癌和宫颈癌）的长期趋势。
DALYs计算为过早死亡导致的生命年损失（YLL）与残疾生存年数（YLD）之和。YLLs使用卫生福利部健康促进署的特定癌症死亡率数据，根据特定年龄的预期寿命来确定。YLDs通过结合癌症发病率、平均残疾持续时间和残疾权重进行估计，数据来源于台湾癌症登记处。结果以每10万人口的DALYs表示。
在过去12年中，疾病负担显著增加。口腔癌从每10万人口263个DALYs增至368个（增加40%），结直肠癌从343个增至563个（增加64%），乳腺癌从446个增至782个（增加75%），而宫颈癌的负担在2010年至2017年间从每10万人口168个降至147个，降幅为13%。在癌症分期方面，YLDs的影响主要在癌症IV期（口腔癌）、0期（结直肠癌和宫颈癌）以及I期（乳腺癌）。
从2005年到2017年，口腔癌增加了40%，结直肠癌增加了64%，乳腺癌增加了75%，而宫颈癌在2010年至2017年间下降了13%。YLDs的贡献在口腔癌IV期、结直肠癌和宫颈癌0期以及乳腺癌I期最高。所有癌症类型中，DALYs最高的始终出现在50 - 69岁年龄组，突出了中年人群的重大负担。
